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1. Dermatology
1. A 45 years old male has multiple hypoaesthetic mildly erythematous large plaques with
elevated margins on trunk and extremities. His ulnar and lateral popliteal nerves on both sides
were enlarged. Most probable diagnose?
A. Hereditary sensory neuropathy
B. Leprosy
C. Motor Neuropathy
D. Sarcoidosis
E. Neurofibromatosis
2. A patient experience pain at the site of a lower extremity ulcer that persistently wake him
from sleep and remits only when he hang his legs over the side of the bed. Most likely diagnosis
A. Arterial ulcer
B. Venous ulcer
C. Pressure ulcer
D. Diabetic foot ulcer
E. Pyoderma gangrenosum
3. A 27 years old male develop warts on his hands. Which of the following is the correct
statement concerning these lesions?
A. Are viral in etiology
B. Are found mainly in patient with lymphoma
C. Are contagious in children only
D. May be pre malignant lesions
E. May be treated with Griseofulvin
4. An 18 years old male presents with pallor, glossitis, cheilitis and vitiligo. Which is the most
likely diagnosis?
A. Sickle cell anemia
B. Cold agglutinin syndrome
C. Methhemoglobinemia
D. Pernicious anemia
E. Polycythemia
5. A 23 year old medical student appearing in exam complains of soreness off his tongue. On
examination he has an ulcer on the tip of tongue. The patient reports it arose in the last exams
as well and healed spontaneoulsy in about 5 days. The condition most likely is
A. Apthous ulcer
B. Geographic tongue
C. Median rhomboid glossitis
D. Lichen planus
E. Candidiasis

2. 6. A 23 year old medical student comes to your office because he notes an area of itching
scaling and redness on the glans penis. The lesion seems to wax and vane and at times it is
almost completely resolved. It is aggravated by using antiseptics soap and perfumes. He is
otherwise healthy except for seasonal allergies for which he takes an over-the-counter
medicine to treat as needed. What do you suspect?
A. Recurrent herpes genitalis
B. Fixed drug reaction
C. Lichen planus
D. Zoon balanitis
7. A 20 years old girl presents with fever and sore throat for 3 days followed by papulovesicular
rash for one day. The diagnosis is
A. Chicken pox
B. Dengue fever
C. Measles
D. Rubella
E. Food allergy
8. A family present with itching all over the body which is more at night for 2 weeks. Itching
involves the genital area as well. They had a holiday trip to murree and stayed in a local hotel.
What is likely condition?
A. Actopic dermititis
B. Chicken pox
C. Food allergy
D. Tinea corporis
E. Scabies
9. A 18 month old boy presents with itchy lesions on his left arm for 10 days. On examination
the lesion has central clearing with marginal erythema, papules and scaling. He has a pet cat
with which he is fond of playing. Which diagnosis should be considered?
A. Contact dermatitis
B. Cat Scratch disease
C. Discoid eczema
D. Psoriasis
E. Tinea corporis
10. A 6 months old infant is diagnosed with scabies. Treatment of choice is
A. 10% sulfur in petroleum
B. Topical 5% permethrin
C. Topical 1% permethrin
D. Oral ivermectin
E. Topical lindane

3. 11. Lishmaniasis is carried by
A. Sandflies
B. Mosquitoes
C. Deer flies
D. Tick
E. Mites
12. A 10 year old girl presents with pustules on her face for 3 days. Some of them jas developed
yellowish crusting. What is the treatment of choice?
A. Cloxacillin
B. Ceftriaxone
C. Cefrofloxacin
D. Gentamycin
E. Doxycycline
13. An infant presents with yellowish discolouration of the skin with assetuation in nasolabial
folds but no scleral icterus. Which of the following will lead to correct diagnosis?
A. Asking about recent diarrhea and weight loss
B. Obtaining serum transaminase and liver ultrasound
C. Asking about protein intake
D. Asking about vegetable intake
E. Asking about calcium intake
14. A 30 years old male present with recent onset of arthritis involving small joints of both
hands along with backache. History reveals that he was suffering from psoriasis for the last 3
years. At present psoriasis involves 35% of his body surface area. What is the treatment of
choice?
A. Emollients
B. NSAIDs
C. Phototherapy
D. Systematic disease modifying drugs
E. Topical mixed preparation of drugs
Psychiatry & Behavioral Sciences
1. In a patient with panic disorder treatment of choice is
A. Haloperidol
B. Olanzapine
C. Quetiapine
D. Benzodiazepines
E. Paroxetine

4. 2. Hallucinations are perceptions that occurs
A. In absence of a stimulus
B. In presence of a stimulus
C. Due to misinterpretation of a sensory stimulus
D. Inside a person's mind
E. With the person's will
3. Which of the following is an SNRI (serotonin noradrenaline reuptake inhibitor)
A. Imipramine
B. Venlafaxine
C. Citalopram
D. Clozapine
E. Haloperidol
4. Which of the following is a mood stabilizer
A. Imipramine
B. Alprazolam
C. Lorazepam
D. Topiramate
E. Trazodone
5. A false unshakeable belief, held with firm convection even in presence of a contradicting
evidence and cannot be explained by the person's social and cultural background ia called
A. Hallucination
B. Delusion
C. Reflex hallucination
D. Illusion
E. Knight's move or derailment
6. In patient of delirium (acute confusional state) the core feature is
A. Delirium
B. Nightmare
C. Blunt affect
D. Fluctuating level of conciousness
E. Overtalkitiveness
7. Extrapyramidal side effects of antipsycotics include
A. Diarrhea
B. Vomiting
C. Raised intracraneal pressure
D. Dystonia
E. Dizziness

5. 8. After witnessing a violent arguments between her parents a young girl develop blindness.
The examination of her eye reveals no pathology. What is the most likely diagnosis?
A. Conversion reaction
B. Epilepsy
C. Glaucoma
D. Cataract
E. Retinal detachment
9. Present of insight in a patient is suggested by
A. Patient is unwilling to accept help
B. Patient agrees to what the family says
C. Patient has overvalued ideas
D. Patient recognizes that he has a psychiatric illness
E. Patient is brought against his will
10. Impaired cognitive state is a hallmark of
A. Panic disorder
B. Obsessive compulsive disorder
C. Acute stress reaction
D. Delirium
E. Conduct disorder
11. In essence the defense mechanisms are
A. Defense against anxiety
B. Ways on convincing others of one's rightness
C. Escape reactions
D. Conscious self-deception
E. Maladaptive coping strategies
12. Which defense mechanism is called queen of defense mechanisms
A. Reaction formation
B. Repression
C. Projection
D. Withdrawl
E. Regression
13. 8 years old boy has recurrent allergies and must receive injections to counteract them. He
became fearful and cried whenever he get his injections but now just the sight of a nurse make
him fearful and tearful. What is the condition stimulus in this example.
A. Nurse
B. Injections
X. Doctor
D. Allergies
E. Crying

6. 14. The sick role (patient role) involves
A. Being blamed for being ill
B. Commitment to get unwell
C. Commitment to not follow medical advice
D. Being excused from various obligations
E. Commitment to not take treatment
15. An adult patient in a medical ward may start to insist to be examined by one particular
doctor, feels that the same doctor comes to his bed first and wants to spend longer time in the
company of the same doctor. The doctor on account of his physical appearance, mannerism or
personal qualities reminds the patient of his/her father. This can be explained by the
phenomena of
A. Confidentiality
B. Informed consent
C. Transferase
D. Counter transferase
E. Resistance
Medicine
1. A 20 years old female presenting with menorrhagia and epistaxis. Investigstion revealed
Factor VIII deficiency with prolong bleeding time.
The most probable diagnosis is
A. Hemophilia A
B. Hemophilia B
C. Von Willibrand disease
D. Idioparhic thrombocytopenia purpura
E. Anti phospholipid syndrome
2. Most reliable criteria for flare of disease in a patient with SLE is
A. Depending on Malar rash and aggravation of Rahnaud's phenomena
B. Falling level of C3 and C4 with raising titre of Anti ds DNA
C. Photosensitvity with throbbing hearache
D. Painful digital ulcers with dangrenous changes
E. Severe depression with suicidal ideas
3. Diagnosis of dermatomyocitis is confirmed by
A. Characteristic skin changes: heliotrope rash and gottron patches
B. Dysphagia with proximal muscle power of 3/5 in pelvis and shoulder girdle
C. EMG study of involved muscle group
D. Muscle biopsy of selected muscle groups and finding characteristic changes.
E. Raised muscle enzyme level (CPK aldolase-ALT & AST) & raise ESR.

7. 4. Osmotic diarrhea may be caused by?
A. Zollinger ellison syndrome
B. Lactase deficiency
C. Motility disorder
D. Hyperthyroidism
R. Hypothyroidism
5. A Caput Medosa lesion on abdomen is associated with
A. Pulmonary hypertension
B. Portal hypertension
C. Secondry hypertension
D. Hypotension
E. Intracraneal hypertension
6. Which factor can cause hepatic encephalopathy in hepatic cirrhosis?
A. Diarrhea
B. Constipation
C. Low protein diet
D. Anemia
E. Deranged coagulation profile
7. A 30 year man has presented to hospital with 2 hours history of profused diarrhea associated
with vomitting. He appears toxic and dehydrated. He had dinner in function in which multiple
meet dishes were served 3 hours earlier. What is the most likely cause of diarrhea?
A. Vibrio cholera
B. E. Coli
C. Salmonella
D. Shigella
E. Staphylococcus aureus toxin
8. Hyperprolactinemia causes
A. Increased chance of pregnancy
B. Decreased chance of pregnancy
C. Increased chance of abnormal babies
D. No changes in chances of pregnancy
E. Visual field defects
9. Somogyi phenomenon seen in diabetic patients
A. Is seen in patients taking metformin
B. Is seen in patient taking insulin
C. Is seen in case of insulinoma
D. In responce to diurnal hormonal responce
E. Indicates effective management

8. 10. Transverse Myelitis has following characteristic features
A. Sensory involvement only
B. Motor sensory and autonomic dysfunction component in presentation
C. Assymetrical presentation
D. Motor neurological defect only
E. Presence of extradural spinal neurological compression lesion
11. A person has halted, fragmented, effortful speech but relatively well preserved
comprehension.He is suffering from
A. Wernike Aphasia
B. Broca Aphasia
C. Conduction Aphasia
D. Nominal Aphasia
E. Dysarthria
12. A 33 years old male complains of paroxysmal stereotype episodes consisting of raising
epigastric sensory feeling and fair lasting upto a minute and followed by confusion lasting up to
an hour. During these episodes wife observes him lip smacking, chewing and swallowing
movements. The most likely diagnosis is
A. Frontal lobe epilepsy
B. Occipital lobe epilepsy
C. Parietal lobe epilepsy
D. Temporal lobe epilepsy
E. Schizophrenia
13. In acute infective endocarditis commonest causative organism is
A. Staphylococcus aureus
B. Streptococcus Viridian
C. Streptococcus pyogenes
D. Enterococci
E. Streptococcus pneumonia
14. The predective test to detect ischemia of coronary arteries is
A. HIDA scan
B. Iodine 131 scan
C. Thalium scan
D. Bone scan
E. DEXA scan
15. Type II respiratory failure is best treated with
A. Invasive ventilation
B. Domiciliary oxygen
C. Non invasive ventilation

9. D. Venturi mask
E. Rebreathing mask
16. A 32 yeara old female patient has low Hb with low MCV, MCH and MCHC. What shoukd be
the next investigation?
A. Serum Ferritin
B. Serum Follate
C. Serum B-12
D. Serum Haptoglobin
E. Reticulocyte count
17. Among following the most specific antibody in SLE is
A. Anti ds DNA
B. Anti sm Antibody
C. Anti Ro Antibody
D. Anti Nuclear Antibody
18. In gulcagonoma, an alpha cell pancreatic malignany, which is the most likely associated skin
lesion
A. Acanthosis Nigrican
B. Eryhtema chronicum migrans
C. Ichthyosis
D. Necrolytic migratory erythema
E. Panniculitis
19. A 64 years old woman presents with fever marked anxiety agitation palpitation marked
muscle weakness and diarrhea. Examination reveals that she has goiter and is in fast atrial
fibrillation with a ventricular rate of 135/min . Urine testing reveals evidence of proteins white
cells and RBC. Thyrpid function test reveal TSH of less than 0.05 mU/L. Which diagnosis best fit
this clinical picture.
A. Hypothyroidism
B. Pheochromocytoma
C. Paroxysmal Atrial fibrillation
D. Thyroid storm
E. Urinary tract infection
20. A brain disorder marked by gradual deterioration of mental capacity, memory impairment
and confusion is known as
A. Alzheimer's disease
B. Cerebral palsy
C. Tourette's syndrome
D. Myasthenia gravis
E. Motor neuron disease

10. 21. A 24 year old patient of Mitral valve disease present with complaints of 01 day history of
shortness of breath. On examination is HR is 118/min. Pulse is ieregularly irregular. He has
bilateral basal crackles. On cardiacl auscultation his findings will be
A. Ejection systolic murmur
B. Mid diastloic murmur and presystolic accentuation
C. Mid diastloic murmur
D. Pan systolic murmur
E. Machinery murmur
22. Which of the following is included in the major criteria of rheumatic heart disease.
A. Migratory arthritis
B. Arthralgia
C. Prolonged PR interval
D. Raised ESR
E. Elevated ASO titers
23. A 38 years old soldier presents qith 1 months H/O productive cough with scanty
hemoptysis, low grade fever and weight loss. CXR show fibronodular opacities in the left apical
region. Which test has quickest and the most sensitive yield of confirming mycobacterial
etiology?
A. Blood culture
B. Bactec for mycobacterium tuberculosis
C. Gene Xpert
D. Montoux test
E. Sputum for AFB
24. A patient has reported for his 1st hemodialysis session dor renal faikure. While evaluating
his lab reports which factor would be the best indicator of chronicity of his disease
A. Serum potassium level of 6.6 mol/L
B. Serum creatinine level of 11mg/dL (972mcmol/L)
C. Serum urea level of 300 mg/dL (107mmol/L
D. Blood Hb of 7.4 gm/dl
E. Serum sodium level of 138 mEq/L
25. Diagnosis of ankylosing spondilytis is most likely in a case with presentation as
A. 30 years old male with inflammatory low backache with bilateral Sarcroillitis on Xray
B. 50 years old male with backache HLA B27+ve with normal sarcoiliac joint xray
C. History of Uveitis in HLA B27+ve patient with normal spine and SI joint
D. Patient with ulcerative colitis and recent onset bilateral sarcoilitis and knee joint effusion
E. Assymetruc oligo-artheritis of lower limbs with preceding history of Uveitis
26. The most important initial step in management of acute pancreatitis is
A. ERCP
B. Fluid replacement

11. C. IV antibiotics
D. Keep the patient NPO
E. Sandostatin
27. A pituitary tumor that produce through the diaphragma sella is most likely to cause
A. Bilateral lower field defect
B. Bitemporal hemianopia
C. Binasal hemianopia
D. Central scotomata
E. Diplopia
28. Mysthenia gravis ia a disease resulting from impaired action at
A. Neuromuscular junction
B. Retinal cones
C. Anterior horn cella
D. Limbic cortex
E. Posterior column
29. A 20 years old boy presents with an episode of loss of consciousness followed by jerky
movements of all 4 limbs. It is associated with tongue bite and loss of control on urination.
Among following the most likely cause of his ailment is
A. Syncope
B. Stroke
C. Grand Mall epilepsy
D. Hypothyroidism
E. Psycogenic reaction
30. CAD is least likely to be associated with
A. Age
B. Sex
C. Homocystinuria
D. Infective Endocarditis
E. Diabetis mellitus
Gyne & Obs
1: A 35 years old Para 1 has severe dysmenorrhea for 6 months. Clinically Endometriosis is
suspected. Which of the following investigations would provide definite diagnosis for
Endometriosis?
A. High Vaginal Swab
B. Pelvic Ultrasound Scan
C. Laparoscopy
D. Endometrial Biopsy
E. Serum CA 125 level

12. 2: A 22 years old nuliparous has premenstrual pain and mood changes of an extent that abrupt
her daily activities. Which of the following is the 1st line hormonal treatment for her?
A. Combined oral contraceptive pills
B. Oestradiol paches
C. Levonorgesterol cobtaining intrauterine device
D. Oral progesterones
E. Injectable progesterones
3: A 25 year old lady has sepsis induced miscarriage. She develops conjunctivitis and usg shows
collection of fluid in peri hepatic region. Which can be the most likely causative organism in her
case?
A. Trachomona Vaginalis
B. Chlamydial infection
C. Gonococcal infection
D. Herpes simple virus
E. Gardenella vaginalis
4: Which of the following diagnostic modalities along with clinical history is considered most
optimal for the diagnosis of an ectopic pregnancy
A. Trans abdominal scan + Blood complete Picture
B. Urine pregnancy test + S bHCG level
C. Trans abdominal scan + S bHCG level
D. Trans abdominal scan + urine pregnancy test
E. Blood CP, Group & Save + Trans vaginal scan
5: A 25 years old P1+0 had suction evacuation for molar pregnancy. Her follow up advice would
include
A. Fortnighly levels of S bHCG till 2 normal levels
B. Biweekly levels of S bHCG till normal
C. Contraception is not required
D. Hormonal contraception can be taken before S bHCG returns to normal
E. No risk of developing choriocarcinoma after complete mole.
6: A 27 years old married woman came with complaints of white vaginal discharge associated
with severe vulval itching. On examination there is vulvar erythema and per speculum
examination reveals thick white curdy discharge. Her vaginal swab for C/S sent for
confirmation. Which of the following is the provisional diagnosis on basis of clinical
examination?
A. Bacterial vaginosis
B. Candidiasis
C. Chlamydia infection
D. Gonorrhea
E. Trichomoniasis

13. 7: The most recommended surgery for utero vaginal prolapse is
A. Manchester Repair
B. Vaginal hysterectomy
C. Ventrosuspension
D. Sarco colpopexy
E Anterior and posterior colpo perineoraphy
8: A mother brings her daughter in opd with history of primary amenorrhea but she informs you
that she complains of cyclic abdominal pain. She has normal secondry sex characteristics. On
local examination she has normal external genitelia and bluish bluging membrane is seen at
vulvula. Treatment of this patient include
A. Vaginoplasty
B. Combined Oral Contraceptive pills
C. Hysterectomy
D. Cruciate incision for imperforate hymen
E. Reassurance
9: A 29 years primigravida presents in emergency with severe headache and burning of vision.
At 36 week of gestation. Fetus is alive and right for dates. The drug or choice for seizure
prophylaxis is
A. Diazepam
B. Lytic cocktail
C. MgSO4
D. Phenytoin Sodium
E. Sodium Valproate
10: A 21 years old PG presented in emergency at 29 week gestation. She has raised blood
pressure, brisk reflexes, uterus smll for dates with moderate pedal oedema. All these are signs
of
A. Normal pregnancy
B. Pre Eclampsia
C. Chronic hypertension
D. Small for gestational age
E. Intra uterine growth retardation
11: A PG at 32 weeks if gestation presents with bp 140/100 at 2 ocassions 4 hours apart. Urine
dipstick test is normal and previos internatal visits show normal BP. What is likely diagnosis.
A. Chronic hypertension
B. Gestational hypertension
C. Pre eclampsia
D. Eclampsia
E. Renal hypertension

14. 12: An 18 years old girl presents with complaints of pain and difficulty in passing urine. Her
secondry sex characters are well deceloped. On examination there is bluish bludge at introitis.
Which of the following is likely diagnosis?
A. Bilateral ovarian cysts
B. Endometriosis
C. Imperforate hymen
D. Pelvic inflammatory disease
E. Polycystic ovarian disease
13: A primigravida reports to labour ward with history of palpable contraction. 31 weeks
gestation. The tocolytic of choice is
A. Retrodine
B. Ventolin
C. Nifedipine
D. Magnesium sulphate
E. Dexamethasone
14: A G3P2 previous LSCS patient presents at 32 weeks with history of mild painless vaginal
bleeding since 1 hour. The most probable diagnosis is
A. Placental abruption
B. Placenta previa
C. Vasa previa
D. Blood show
E. Urerine rupture
15: The drug of choice for initial management of postpartum haemorrhage is
A. Misoprostol
B. Oxytocin
C. Ergometrine
D. Syntometrine
E. Protaglandin F2 alpha
Eye
1: A 64 years old hypertensive lady suffers from acute visual deterioration in her left eye.
opthalmoscopy reveals extensive retinal hemorrhages and edema involving entire fundus.
What is the most likely diagnosis?
A. Branch retinal vein occlusion
B. Central retinal vein occlusion
C. Hemi retinal vein occlusion
D. Branch retinal artery occlusion
2: A pseudophakic patients complains with gradually decreasing vision and glares 6 months
after surgery. On examination there is whitish membrane behind the intra ocular lens. Which
laser will be used to treat this condition?

15. A. Argon laser
B. YAG laser
C. Crypton laser
D. CO2 laser
E. Excimer laser
3: The commonest opthalmagic abnormality in a newly delivered baby is
A. Congenital cataract
B. Corneal clouding
C. Exopthalmos
D. Retinoblastoma
E. Primary congenital glaucoma (bupthalmos)
4: A 2 years baby with congenital ptosis came to your opd. What is the most important sign
would you like to check before referring to ophthalmologist.
A. Levator function
B. Markus Gunn jaw wiking
C. Pupillary reaction
D. Occlusion of visual axis by lid
E. Ocular motality defects
5: A patient comes to you with pain redness and photophobia in right eye. Examination shows
Circum-Corneal congestion. Which condition is most likely?
A. Blepharitis
B. Bacterial conjunctivitis
C. Viral conjunctivitis
D. Uveitis
E. Orbital cellulitis
6: A 17 years old motorcyclist met an accident. He noticed double vision especially when he
looks up and down. Which bone is most likely fractured?
A. Frontal
B. Lacrimal
C. Maxillary
D. Zygomatic
E. Ethmoid
7: Commonest cause of cataract is
A. Acquired childhood cataract
B. Congenital cataract
C. Steroid induced cataract
D. Senile cataract
E. Traumatic cataract

16. 8: A patient needs posterior capsulotomy. Which laser is best suited to perform this procedure?
A. Argon laser
B. YAG laser
C. Excimer laser
D. Diode laser
E. CO2 laser
9: A 5 years old child brought by his mother with complaint of a decreased vision left eye. Exam
of eye revealed no abnormality in the fundus and media. He had hypermetropia of +2.5D in RE
visual acuity RE-6/12 with glass. Colour vision was normal visual acquity LE-6/6 unaided. He is
case of
A. Anisometropia
B. Anisometropic amblyopia
C. Starbismus
D. Keratoconus
E. Amblyopia
10: A patient 20 years old who has vision of 6/24 in RT eye and 6/18 in LT eye complaints of
decreased vision in both eyes. He is not using glasses. His vision improves to 6/9 on pinhole
exam. What could be the possible cause of decreased vision?
A. Macuolpathy
B. Optic atrophy
C. Amlyopia
D. Refractive error
E. Strabismus
11: A young boy complains of difficulty in reading white board in the class room but has no
problem in reading books. What is the most appropriate diagnosis?
A. Myopia
B. Hypermetropia
C. Astigmatism
D. Presbyopia
E. Anisometropia
12: A patient has suffered acute primary angle closure glaucoma in right eye and survived vision
due to prompt and timely treatment. What is the best option to prevent similar episodes in the
other eye?
A. Topical pilocarpine
B. Topical beta blocker
C. Trabiculectomy
D. Peripheral iridectomy
E. Laser iridectomy

17. 13: A 6 months old child is brought to OPD with complaints of watering photophobia and
decreased vision. He has hazy corneas, enlarged corneal diameter and enlarged eye balls. Likely
diagnosis is
A. Bupthalmos
B. Congenital myopia
C. Congenital blockage of nasolacrimal duct.
D. Microcornea
E. Open angle glaucoma
14: Which of the following medication immediately lowers intraocular pressure during an attack
of acute congestive glaucoma?
A. Brimonidine
B. Pilocarpine
C. Timolol
D. Mannitol
E. Atropine